We propose to assess educational performance and achievement-specific cognitive abilities, neuromotor development, and learning-geographically representative cohort of 1,105 low birthweight infants. This unique cohort, comprised of 85% of all infants weighing less than or equal to 2000 grams born between 9/1/84 and 6/30/87 in the three central New Jersey counties of Middlesex, Monmouth and Ocean, was ascertained at birth and underwent a prospective, timed series of cranial ultrasound scans to image brain lesions in the first weeks of life. More than 86% of the 897 survivors have been followed successfully through the difficult-to-trace pre-school years, and intermediate data are thus available on neurodevelopmental outcome, sensory deficits, behavior, and intercurrent illnesses and hospitalizations. We have found that certain patterns of cranial injury imaged on ultrasound are powerfully associated with neurologic and cognitive deficits in infancy. The objective of this study is to link ultrasonographic indicators of brain injury in the neonatal period to school performance. We hypothesize that milder forms of cranial injury (which were not associated in our study with major neurologic deficits in infancy) will be associated with the learning disabilities and other school-age abnormalities that are found so commonly in low birthweight infants.